253. A satisfactory fall in the incidence of infectious syphilis has been recorded over the last few years, the reduction covering all formus of the disease with the exception of late cardiovascular syphilis. Here there has been recently a slight rise, possibly connected with the stress of increasing industrialization in the Colony.
254. Other venereal diseases which have also shown a downward trend incidence are gonorrhoea and chancroid.
255. At Appendix 5 is a composite table giving details of the new attendances at Social Hygiene Clinics during the year.
256. There were 704 admissions to the 30-bed Female Social Hygiene Hospital, Wan Chai, compared to 515 in 1956, 303 of these admissions were in respect of gonorrhoea and ninety five were for syphilitic con. ditions, mostly late latent manifestations of the disease.
257. 3,124 male cases were treated by the Social Hygiene Service at Stanley Prison and 963 females at Lai Chi Kok Prison.
258. Although new antibiotics continue to be recommended for the treatment of all vencreal diseases, there still appears to be little need to depart from the use of penicillin as the routine therapeutic agent. However, since occasional severe penicillin reactions have led to its more cautious use on a mass scale, its routine employment prophylacti- cally was discontinued in June 1957. It is still given if specifically requested by a known contact.
259. Primary, secondary and latent syphilis continue to be treated with a total of 6,000,000 units of Penicillin. Neurosyphilis and cardio- vascular syphilis are treated with 12 million units of penicillin following by iodides.
260. Post-treatment observation following penicillin therapy now extends to six and half years and every effort is being made to continue this follow-up. However, it is only possible to keep one out of ten patients on surveillance beyond the usual two year follow-up period.
261. For gonorrhoea 400,000 units of penicillin (a mixture of 100,000 crystalline penicillin plus 300,000 procaine penicillin) remains the standard dose for male patients, and 1,200,000 units is now the standard dosage for females. The few cases in men which do not respond to 400,000 units clear up with double this dosage or with the addition of 10 gm. of streptomycin.
262. As elsewhere, the complications of gonorrhoea are now rarely seen; the main concern is the rate of re-infection.
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263. Non-gonococcal urethritis is treated with sulphatriad alone or with streptomycin. The aetiology of this condition remains a problem and little advance in knowledge concerning its causation has been made during the yсаг,
264.
Preventive measures for the control of the venereal diseases include contact notification and the follow-up of defaulters from treat- ment by means of letters and personal visits by Social Hygiene Visitors. There were 4,158 contact notifications received in 1957 and 81-5% were successfully traced. Social Hygiene Visitors made a total of 5,848 visits of which 1,436 were to defaulters from treatment. 6,448 letters to defaulters were also sent resulting in 1,637 patients returning to complete their scheduled treatments. In this connexion a close liaison is maintained with the Armed Services.
265. Ante-natal blood tests for syphilis for pregnant women attend- ing both Government clinics and private midwives totalled 27,330 during the year. Of these 979 were positive, giving a positivity rate of 3.5% compared with 3-8% in the previous year.
266. Laboratory studies were continued on penicillin resistant gonococci in males. Special test tubes were made available during the year for the transmission of specimens to be examined at the Pathological Institute for Trichomonas vaginalis.
LEPROSY
267. Clinic services have continued to expand considerably and eleven sessions each week for leper patients were held throughout the Colony, including the New Territories; six of these sessions are held, after the usual working hours, on premises used in normal hours by other medical services.
268. During the year the staff was increased by one Medical Officer, two Nurses, and two Female Leprosy Visitors: the Almoner, previously available only on a part-time basis, undertook full time duties from October 1957.
269. Total attendances at clinics were 31.204; new uttendances numbered 981 of which 436 were freshly discovered cases of leprosy and of these approximately 40% were of the lepromatous type. Male palicots predominated, forming 70% of the new leprosy cases,
270. Of 174 cases recommended for admission 132 were admitted ta Hay Ling Chau Leprosarium during the year.
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